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. 2024 Jul;31(4):695-704.
doi: 10.1007/s12282-024-01584-4. Epub 2024 Apr 27.

Percutaneous ultrasound-guided cryoablation for early-stage primary breast cancer: a follow-up study in Japan

Hisanori Kawamoto  1   2 , Koichiro Tsugawa  3   4 , Yuko Furuya  3 , Kaori Sakamaki  4 , Sayoko Kakimoto  4 , Mina Kitajima  4 , Mariko Nagai Takishita  4 , Mizuho Tazo  4 , Mari Hara Nakano  4 , Takako Kuroda  4 , Ayaka Shimo  4 , Arata Shimo  4 , Yasuyuki Kojima  4 , Makiko Tsuzuki  3   4 , Ai Motoyoshi  4 , Ei Haku  3   4 , Toru Nishikawa  4 , Yoshihide Kanemaki  3   5 , Hidefumi Mimura  5 , Mamoru Fukuda  3
Affiliations

Percutaneous ultrasound-guided cryoablation for early-stage primary breast cancer: a follow-up study in Japan

Hisanori Kawamoto et al. Breast Cancer. 2024 Jul.

Abstract

Background: Ultrasound-guided percutaneous cryoablation (PCA) for early-stage breast cancer (ESBC) can be performed under local anesthesia in an outpatient clinic. This study continues a pilot stage to examine local control, safety, patient quality of life (QoL), satisfaction and cosmetic outcomes of cryoablation for ESBC.

Methods: PCA was performed under local anesthesia for patients with primary ESBC, followed by radiation and endocrine therapies. Oncologic outcomes were examined by imaging (mammography, ultrasound, MRI) at baseline and 1, 6, 12, 24, 36, and 60 months post-cryoablation. EQ-VAS, EQ-5D-5L, subjective satisfaction and Moiré topography were used to measure health-related QoL outcomes.

Results: Eighteen patients, mean aged 59.0 ± 9.0 years, mean tumor size 9.8 ± 2.3 mm, ER + , PR + (17/18), HER2-, Ki67 < 20% (15/18), underwent PCA and were followed for a mean of 44.3 months. No serious adverse events were reported, and no patients had local recurrence or distant metastasis in the 5-year follow-up. Cosmetic outcomes, satisfaction level, and QoL all improved post-cryoablation. Five-year average reduction rates of the cryolesion long, short, and depth diameters, on US, were 61.3%, 42.3%, and 22.8%, respectively, compared to the 86.2% volume reduction rate on MRI. The correlation coefficient between MRI and US measurement criteria was highest for the long diameter. During follow-up, calcification of the treated area was observed in 13/18 cases.

Conclusion: Cryoablation for ESBC is an effective and safe procedure with excellent cosmetic outcomes and improved QoL. This study contributes to the growing evidence supporting cryoablation as a potential standard treatment for ESBC, given compliance to pre-defined patient selection criteria.

Keywords: Breast cancer; Cryoablation; Cryotherapy; Nonsurgical ablation; Outpatient procedure.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
Pre- and post-cryoablation MRI images—pectoralis major muscle burn. MRI images pre- (a) 1 month (b) and 6 months (c) post-cryoablation in a patient 55 years old with 8.9 mm tumor in the left breast. Arrow points to the area of the pectoralis major muscle burns
Fig. 2
Fig. 2
Cryolesion measurements by MRI and US imaging. Post-cryoablation cryolesion images of a patient 67 years old with 12.2 mm tumor in the right breast. Cryolesion’s change over time, as observed by MRI (a) were marked (a1) and measured, and their volume was calculated (a2) using Attractive Basic 3D. Cryolesion as observed by US (b)
Fig. 3
Fig. 3
Tissue cryolesion dimension and reduction rates as measured by MRI and US imaging. Post-cryoablation cryolesion volumes (a) and reduction rate (b), at the indicated post-cryoablation follow-up times, as calculated from MRI images using Attractive Basic 3D. Long (c), short (d), and depth (e) diameter, at the indicated post-cryoablation follow-up times, as measured from US imaging. Mean (x), median (thick line) and outliers (circles) are indicated
Fig. 4
Fig. 4
MG image findings of cases with or without calcifications. Patients underwent MG imaging at 1, 6, 12, 24, 36, and 60 months post-cryoablation. Two cases, one of a patient 67 years old with 12.2 mm tumor in the right breast (a) and another of a patient 72 years old with 7.7 mm tumor in the right breast (b), are presented. Calcification in the spherical area of tissue was observed in some cases after 24 months (a), while in others, no calcification was served (b). The presence or absence of the calcification was not dependent on any of the tested variables. White arrowheads (a) point to the location of the surgical clip. White circles (b) are the surgical clips. Yellow circles (a) mark coarse calcifications
Fig. 5
Fig. 5
Cosmetic outcomes visualization using Moiré topography. Cosmetic outcomes of a patient 67 years old with 12.2 mm tumor in her right breast were visually assessed using Moiré topography at 6, 12, 24, 36, and 60 months after the cryoablation procedure as compared to baseline. No nipple position distortion, breast deformity, or asymmetry was observed. Blue line—used for alignment
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References

    1. Ozmen T, Ozmen V. Treatment changes in breast cancer management and de-escalation of breast surgery. Eur J Breast Health. 2023;19(3):186–190. doi: 10.4274/ejbh.galenos.2023.2023-6-2. - DOI - PMC - PubMed
    1. Angarita FA, Brumer R, Castelo M, Esnaola NF, Edge SB, Takabe K. De-escalating the management of in situ and invasive breast cancer. Cancers (Basel) 2022;14(19):4545. doi: 10.3390/cancers14194545. - DOI - PMC - PubMed
    1. Pusceddu C, Paliogiannis P, Nigri G, Fancellu A. Cryoablation in the management of breast cancer: evidence to date. Breast Cancer (Dove Med Press) 2019;11:283–292. doi: 10.2147/BCTT.S197406. - DOI - PMC - PubMed
    1. Thai JN, Sevrukov AB, Ward RC, Monticciolo DL. Cryoablation therapy for early-stage breast cancer: evidence and rationale. J Breast Imaging. 2023;5(6):646–657. doi: 10.1093/jbi/wbad064. - DOI - PubMed
    1. Carriero S, Lanza C, Pellegrino G, Ascenti V, Sattin C, Pizzi C, et al. Ablative therapies for breast cancer: state of art. Technol Cancer Res Treat. 2023;22:15330338231157193. doi: 10.1177/15330338231157193. - DOI - PMC - PubMed